Individual
LAWRENCE A. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4660 KENMORE AVE, STE 1200, ALEXANDRIA, VA 22304-1311
(703) 751-8111
(703) 751-1105
Mailing address
2901 TELESTAR CT STE 300, FALLS CHURCH, VA 22042-1263
(703) 591-1688
(703) 591-1445
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101035587
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031726300
—
DC
01
—
060035109
RAILROAD MEDICARE DC #
DC
01
—
060062641
RAILROAD MEDICARE VA #
VA
05
—
1396749362
—
VA
05
—
182761800
—
MD
Enumeration date
06/08/2005
Last updated
10/28/2020
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